Rhinosporidiosis Clinical Presentation

Updated: May 31, 2017
  • Author: Duane R Hospenthal, MD, PhD, FACP, FIDSA, FASTMH; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
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Presentation

History

Nasal rhinosporidiosis may present with unilateral nasal obstruction or epistaxis. Other symptoms may include local pruritus, coryza with sneezing, rhinorrhea, and postnasal discharge (drip) with cough. Patients often report a sensation that a foreign body is present in their nasal canal.

Eye involvement is initially asymptomatic. Increased tearing may be reported as the disease progresses. Photophobia, redness, and secondary infection may occur.

Skin lesions begin as papillomas that gradually become verrucous.

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Physical

Soft polyps may develop on the nose or eye. These polyps are pink to deep red, are sessile or pedunculated, and are often described as strawberrylike in appearance. Because the polyps of rhinosporidiosis are vascular and friable, they bleed easily upon manipulation. This appearance results from sporangia, which are visible as gray or yellow spots in the vascular polypoid masses.

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Causes

The etiologic agent of rhinosporidiosis, R seeberi, has traditionally been considered a fungus. Recent 18S ribosomal ribonucleic acid (rRNA) gene analysis has placed R seeberi into a novel group of aquatic parasites of the class Mesomycetozoea, some of which cause similar diseases in amphibians and fish. [15, 16, 17]

Most persons with rhinosporidiosis have had bathing or working exposure to stagnant water. [6, 29]

No immune deficiency has been associated with infection.

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